Background:A less invasive alternative to surgical resection, endoscopic submucosal dissection (ESD) allows for the en-bloc removal of malignant colorectal lesions. Important steps in patient selection include lesion categorization, architectural detection, and depth of invasion estimate. Paris, lateral spreading tumor (LST), narrow band imaging (NBI), international colorectal endoscopic (NICE), and Japanese NBI expert team (JNET) are just a few of the categorization methods that experienced endoscopists have incorporated into their daily practice to improve the accuracy of lesion detection. In cases of big, depressed, and protruding colonic lesions with shallow submucosal invasion, major medical organizations advise using endoscopic shunt drainage (ESD) instead of granular filtration (NG). As the depth, tumor location, and tumor size all rise, the likelihood of submucosal invasion increases. Because of its better curative resection rate and lower recurrence rate, endoscopic submucosal resection (ESD) is the method of choice for managing bigger colonic lesions compared to endoscopic mucosal resection (EMR). As much as 11% and 16% of patients, respectively, may experience serious consequences such bleeding and perforation. Problems with insurance coverage, a shortage of skilled clinicians, and individual patient factors including obesity and a high percentage of previously treated lesions make ESD difficult to conduct in developed nations.